Natural orifice transluminal endoscopic surgery (NOTES), which obviates the need for cutting through the abdominal wall, is a new and promising surgical technique. In NOTES, an incision is made from within a natural orifice, for example the gastrointestinal (GI) tract or other body lumen, to reach the peritoneal cavity or other organs. It is believed that NOTES will provide less invasive surgery reducing recovery time. It is also believed that the new procedure will generate less discomfort in the patient with fewer incisional complications including pain, hernias, and external wound infections. There should also be potentially fewer adhesions and a decreased need for anesthesia when NOTES is used. Hospital stays should also be shorter with a concomitant reduction in nosocomial infections. There should be virtually no visible scarring resulting from a NOTES procedure.
Closing perforations and openings after iatrogenic procedures, including NOTES procedures, requires wound closing instruments, systems and methods to prevent leakage into the peritoneal cavity or other body organs. At a recent meeting of a group of surgeons from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and gastroenterologists from the American Society of Gastrointestinal Endoscopists (ASGE), a framework for the initial safe application of NOTES procedures was discussed and worked out. It was agreed that further expansion of the use of NOTES procedures depends inter alia on an effective collaboration with industry. Development of effective instruments allowing traction/countertraction and stable optical platforms, as well as the means to control hemostasis, prevent infection, securely close the visceral wall, and perform suturing functions and gastrointestinal anastomoses were deemed critical.
Therefore, the development of new surgical ports and compression clips for use in NOTES and other surgical procedures is desirable.